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FDA Greenlights ‘Mix and Match’ COVID Boosters

The FDA authorized booster doses of Moderna and Johnson & Johnson’s COVID-19 vaccines and also authorized a “mix and match” or heterologous approach to boosters for all three available vaccines (including Pfizer’s) in the indicated populations, the agency announced on Wednesday.

Ultimately, the FDA went with what was recommended by their advisory panel, the Vaccines and Related Biological Products Advisory Committee (VRBPAC), which voted for a half-dose Moderna booster in adults ages 65 and up, adults ages 18-64 at high risk of severe COVID, and adults 18-64 with frequent occupational and institutional exposure to SARS-CoV-2, at least 6 months after completing the primary series.

A booster of Johnson & Johnson vaccine is authorized for all adults ages 18 and up who received the Johnson & Johnson vaccine, at least 2 months after completion of the single-dose regimen.

For the heterologous boosters, the agency specified that they are authorized for “eligible individuals.” These individuals may receive a booster dose of a different vaccine than their primary series “with a different available COVID-19 vaccine” if they are among the populations indicated for boosters, given at the same recommended interval (after 2 months if Johnson & Johnson was the primary vaccine, or after 6 months for Moderna or Pfizer).

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